ORIGINAL ARTICLE Epidemiology of fracture in the Russian Federation and the development of a FRAX model Olga Lesnyak & Olga Ershova & Ksenia Belova & Elena Gladkova & Olga Sinitsina & Olga Ganert & Marina Romanova & Vitalij Khodirev & Helena Johansson & Eugene McCloskey & John A Kanis Received: 7 March 2012 / Accepted: 8 March 2012 / Published online: 9 May 2012 # International Osteoporosis Foundation and National Osteoporosis Foundation 2012 Abstract Summary The incidence of hip, forearm and humeral frac- tures was studied in two cities from the Russian Federation. Fracture rates were used to create a FRAX model for Russia and to estimate the current and future burden of fracture. Purpose There is scant information on the epidemiology of fracture in Russia. The aim of the study was to determine the incidence of major fractures in order to populate a new FRAX model and to characterise the burden and future burden of fractures. Methods The number of hip, forearm and humeral fractures was determined in two Russian cities with a well-defined catchment population over a 2–3-year period. Incidence rates for the two cities were merged and used to populate a FRAX model for Russia. Incidence rates were also applied to the general population in 2010 and 25 years later in 2035. Results A total of 6,012 fractures were documented. For hip fracture, 27 % of cases in Pervouralsk and 1.8 % in Yaroslavl were not registered in the hospital data base. The incidence of index fractures increased with age and was higher in women than in men. The lifetime probability of hip fracture at the age of 50 years was 4 % in men and 7 % in women. The total number of hip fractures estimated in 2010 (112,000) is expected to rise to 159,000 in 2035. The estimated number of major fractures will rise from 590,000 to 730,000 over the same time interval. Conclusions Fragility fractures pose a serious health care problem in Russia. Urgent steps are needed to improve the acute management of hip fracture and long-term care of other osteoporotic fractures. Keywords Burden of fractures . Fracture probability . Forearm fracture . FRAX . Hip fracture . Humerus fracture Introduction FRAX® is a computer-based algorithm (http://www.shef.ac. uk/FRAX) developed by the World Health Organization Col- laborating Centre for Metabolic Bone Diseases and first re- leased in 2008. The algorithm, intended for primary care, calculates fracture probability from easily obtained clinical risk factors in men and women [1–3]. The output of FRAX is the 10-year probability of a major osteoporotic fracture (hip, clin- ical spine, humerus or wrist fracture) and the 10-year proba- bility of hip fracture. It has been widely used for the assessment of patients since the launch of the website in 2008, and cur- rently makes about 10,000 calculations per working day. Fracture probability varies markedly in different regions of the world [4] so that FRAX® models are calibrated to those countries where the epidemiology of fracture and death is known. Models are currently available for O. Lesnyak (*) : E. Gladkova : V. Khodirev Department of Family Medicine, Ural State Medical Academy, 185, Volgogradskaya Street, Yekaterinburg 620102, Russian Federation e-mail: lesnyak@sky.ru O. Ershova : K. Belova : O. Sinitsina : O. Ganert : M. Romanova Department of Internal Diseases, Yaroslavl State Medical Academy, 11, Zagorodnij sad street, Yaroslavl 150003, Russian Federation e-mail: yarosteoporosis@list.ru H. Johansson : E. McCloskey : J. A. Kanis (*) WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK e-mail: w.j.pontefract@sheffield.ac.uk Arch Osteoporos (2012) 7:67–73 DOI 10.1007/s11657-012-0082-3